• Can J Cardiol · Dec 2014

    Review

    Innovative approaches in the perioperative care of the cardiac surgical patient in the operating room and intensive care unit.

    • André Denault, Yoan Lamarche, Antoine Rochon, Jennifer Cogan, Mark Liszkowski, Jean-Sébastien Lebon, Christian Ayoub, Jean Taillefer, Robert Blain, Claudia Viens, Pierre Couture, and Alain Deschamps.
    • Department of Anesthesiology, Critical Care Program, Montreal Heart Institute, and Centre Hospitalier de l'Université de Montréal, Université de Montréal, Montreal, Quebec, Canada. Electronic address: andre.denault@umontreal.ca.
    • Can J Cardiol. 2014 Dec 1;30(12 Suppl):S459-77.

    AbstractPerioperative care for cardiac surgery is undergoing rapid evolution. Many of the changes involve the application of novel technologies to tackle common challenges in optimizing perioperative management. Herein, we illustrate recent advances in perioperative management by focusing on a number of novel components that we judge to be particularly important. These include: the introduction of brain and somatic oximetry; transesophageal echocardiographic hemodynamic monitoring and bedside focused ultrasound; ultrasound-guided vascular access; point-of-care coagulation surveillance; right ventricular pressure monitoring; novel inhaled treatment for right ventricular failure; new approaches for postoperative pain management; novel approaches in specialized care procedures to ensure quality control; and specific approaches to optimize the management for postoperative cardiac arrest. Herein, we discuss the reasons that each of these components are particularly important in improving perioperative care, describe how they can be addressed, and their impact in the care of patients who undergo cardiac surgery.Copyright © 2014 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

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